Insurance

Insurance…

Many patients today are fortunate to have some type of dental insurance. While we do accept some dental insurance we do not accept all insurance. To find out if we accept your dental insurance just call our office. If we do not we will be happy to review your policy and may choose to accept it.

Most dental insurance in purchased through an employer and offered to employees as an employment benefit. The coverage your specific policy provides is determined by the policy your employer purchased. The more money your employer spends on dental insurance the better coverage it will provide. While some policies may be very basic and cover only cleanings and fillings other policies will cover crowns, bridges, root canals and more. The percentage of coverage will also vary depending on the policy your employer purchased. For example some policies will cover 50% of the cost of a crown while some may cover as much as 90%.

Many policies will base their coverage on a usual, customary and reasonable fee more commonly referred to as UCR. What most insurance companies consider usual, customary and reasonable is almost always less than the dentist charges.

By design, dental insurance can be very confusing for most people. We are happy to assist you in determining what coverage you insurance provides. We are usually able to give patients an accurate estimate of what percentage your policy will cover; however insurance companies will never guarantee payment. Therefore the patient is always responsible for any fees or portions of fees their policy does not pay.

As a service to our patients we are happy to submit insurance claims for you. Please remember that your policy is a contract between you, your employer and the insurance company. We are not a part of that contract. We have no control or influence over what you insurance company does. If your insurance company does not reimburse us in a timely fashion we ask that you pay the balance in full. We will then have the insurance check sent to you.

We urge patients to call their insurance company promptly if any delay in reimbursement occurs. The company will usually respond to a policyholder’s complaint much faster than they respond to any request or complaint from us. We also urge patients to let their employer know of any problems they are having with their insurance. The employer who purchased the policy will usually want to know if they have invested in a poor dental policy. The employer may be able to help correct any problems or may choose to purchase a better policy next time.

We will do everything we can to help you maximize your dental benefits and minimize your out of pocket expense. However, we cannot allow patients insurance coverage to dictate what treatment we recommend. Because we are ultimately responsible for the oral health and welfare of our patients, we have to recommend what we consider to be the best care.